Relationship between patient, caregiver, and asthma characteristics, responsibility for management, and indicators of asthma control within an Urban clinic

Successful asthma management in children requires an appropriate division of responsibility for management tasks between patient and their family. Non-adherence may result without appropriate assignment or acceptance of responsibility for these tasks. This study explored the relationship between selected child, caregiver, family, and asthma characteristics and responsibility for self-management activities. Child and caregiver perceived responsibility for selected tasks were determined and described via means and mean summary scores. Child, caregiver, family, and asthma characteristics were determined via interview and chart review and described by means or proportions. Pearson's correlation coefficient (r) examined any relationship between these characteristics and perceived levels of responsibility. Multiple regression examined whether the affect of child, caregiver, family, and asthma characteristics influenced perceived levels of responsibility for asthma management. One-hundred and four child and caregiver pairs were enrolled. Mean caregiver scores for all tasks suggest responsibility for each most of the time. The mean child scores for all tasks suggest an unwillingness to assume responsibility most or all of the time. Regression analysis indicated that patient age (r²=0.344), number of hospital admissions (r ²=0.052), and PEF (r²=0.106) had the best predictive strength for the patient summary score. Only patient age (r=0.486) was a significant predictor for the caregiver summary score. We conclude that children and caregivers perceive differently responsibility for asthma management tasks and patient age had the best predictive strength for both patient and caregiver responsibility.